Can nifekalant hydrochloride be used as a first-line drug for cardiopulmonary arrest (CPA)? : comparative study of out-of-hospital CPA with acidosis and in-hospital CPA without acidosis.
Can nifekalant hydrochloride be used as a first-line drug for cardiopulmonary arrest (CPA)? : comparative study of out-of-hospital CPA with acidosis and in-hospital CPA without acidosis.
复制标题
盐酸尼非卡兰可以作为心肺骤停（CPA）的一线药物吗？
DOI：
10.1253/circj.70.21
复制
发表时间：
2006
期刊：
影响因子：
--
通讯作者：
T. Tanabe
中科院分区：
文献类型：
--
作者：
K. Yoshioka;M. Amino;S. Morita;Y. Nakagawa;K. Usui;Atsuhiko Sugimoto;A. Matsuzaki;Yoshiaki Deguchi;I. Yamamoto;S. Inokuchi;Y. Ikari;I. Kodama;T. Tanabe
背景
室性心动过速和心室颤动 (VT/VF) 的早期除颤是心肺骤停 (CPA) 患者生存的紧急且最重要的复苏方法。我们之前曾报道过尼非卡兰 (NIF) 是日本开发的一种特异性 I(Kr) 阻滞剂，可有效治疗院外 CPA (OHCPA) 患者的利多卡因 (LID) 耐药性 VT/VF。然而，NIF 对伴有酸中毒的 OHCPA 和不伴有酸中毒的院内 CPA (IHCPA) 的影响差异知之甚少。
方法和结果
本研究纳入了2000年6月至2003年5月期间发生的892例CPA中的91例直流电击抵抗性VT/VF。根据东海大学的心肺复苏（CPR）算法，在LID后使用NIF（0.15-0.3 mg/kg）。 OHCPA 和 IHCPA 组的 NIF 组除颤率均高于单独 LID 组，并且即使出现酸中毒也能维持 VT/VF 率降低效果。然而，OHCPA 中偶尔观察到窦性心动过缓，IHCPA 中偶尔观察到尖端扭转型室速。这些不良反应的差异可能与肾上腺素的量、血清钾水平、血清 pH 值以及与 LID 的相互作用有关。
结论
NIF 在两个 CPA 组中均具有良好的除颤效果，并且有望成为 CPR 的一线药物。
BACKGROUND
Early defibrillation of ventricular tachycardia and fibrillation (VT/VF) is an urgent and most important method of resuscitation for survival in cardiopulmonary arrest (CPA). We have previously reported that nifekalant (NIF), a specific I(Kr) blocker developed in Japan, is effective for lidocaine (LID) resistant VT/VF in out-of-hospital CPA (OHCPA). However, little is known about the differences in the effect of NIF on OHCPA with acidosis and in-hospital CPA (IHCPA) without acidosis.
METHODS AND RESULTS
The present study enrolled 91 cases of DC shock resistant VT/VF among 892 cases of CPA that occurred between June 2000 and May 2003. NIF was used (0.15-0.3 mg/kg) after LID according to the cardiopulmonary resuscitation (CPR) algorithm of Tokai University. The defibrillation rate was higher in the NIF group for both OHCPA and IHCPA than for LID alone, and the VT/VF rate reduction effect could be maintained even with acidosis. However, sinus bradycardia in OHCPA, and torsades de pointes in IHCPA were occasionally observed. These differences in adverse effects might be related to the amount of epinephrine, serum potassium levels, serum pH, and interaction with LID.
CONCLUSIONS
NIF had a favorable defibrillating effect in both CPA groups, and it shows promise of becoming a first-line drug for CPR.